App shows ‘excellent diagnostic accuracy’ for atrial fibrillation
The 1-lead electrocardiography, or 1L-ECG, smartphone application demonstrated “excellent diagnostic accuracy” for detecting atrial fibrillation among a cohort of primary care patients in the Netherlands, according to findings recently published in Annals of Family Medicine.
“Medical devices are flooding consumer markets,” Jelle C.L. Himmelreich, MD, MSc, of the department of general practice at Amsterdam Public Health, told Healio Primary Care. “Some of them have the potential to become valuable tools for physicians and patients alike, while others are creating more confusion than solutions.”
The 1L-ECG device in this study shows ECG recordings in 30 seconds via a smartphone application, according to researchers. These recordings are classified several ways, such as either possible atrial fibrillation, normal, unreadable.
Cardiologists validated the 1L-ECG device against the 12-lead ECG (12L-ECG) in 214 patients (mean age, 64.1 years; 53.7% men). They found that the 1L-ECG had a sensitivity of 100% (95% CI, 85.2-100) and a specificity of 100% (95% CI, 98.1-100) for detecting atrial fibrillation/atrial flutter. Regarding any other cardiac rhythm abnormality, the 1L-ECG had a sensitivity of 90.9% (95% CI, 78.3-97.5) and a specificity of 93.5% (95% CI, 88.7-96.7).
“We showed that the device and app are very well able to pick up the cardiac microvoltages that run through the fingertips and can convert these into a signal similar to what a physician as well as an internal algorithm would recognize as an ECG rhythm,” Himmelreich said. “I would thus say that physicians could see this particular device as a reliable tool for acquiring a rhythm strip in primary care patients.”
The 1L-ECG costs approximately $100 to $150 in the United States, according to Himmelreich.
Priya Radhakrishnan, MD, FACP, a clinical professor of medicine at the University of Arizona College of Medicine, who is not affiliated with the study, told Healio Primary Care that apps are emerging in many clinical specialties.
“Apps like this have the propensity for physicians to conduct visits remotely, perform the annual Medicare wellness visits, and triage patients from long-term facilities rather than send them to the ER,” she said. “There is the potential to ensure that physicians and other providers are able to truly provide population health.”
Radhakrishnan added that Himmelreich and colleagues’ findings add to the growing body of evidence that suggests apps will play a key role in medicine in the next decade.
“It is likely that with widespread availability and lower costs, this technology has the opportunity to be used widely,” Radhakrishnan said. “It will be interesting as larger studies are conducted [to see] whether the diagnostic accuracy holds.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures. Healio Primary Care could not confirm Radhakrishnan’s relevant financial disclosures at the time of publication.